014 (2)FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton ~'
Date Received: ~ / ~, /
FOIL Ser. #:
DEPARTMENT.:
ASSESSOR ^
ACCOUNTING ^
CODE ENFORCEMENT ^
PLANNING ^
ZONING ^
FIRE INSPECTOR ^
HIGHWAY ^
RECENEI~9.k' TAXES ^
RECREATIO '~ i
TOWN CLERK
WATER/5EWER D
DOG CONTROL OFFICER ^
TOWN ENGINEER D
TOWN ATTORNEY ^
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
~ l 3 / r .~
(init)
Date Applicant Contacted:
l /~/~
Date FOIL fulfilled or denied: ~ / ~ /
Closed by: ~,~
Date:
L/~L/~
Notes:
Amount Due: Pages for a total of $ 1 r
Name: ~ ^ check here if you are
Address: requesting that the records
be mailed to this address.
Agency or firm: '
Telephone #: (g~ ~~_ FAX #: (g~{S) 3 ~ ~ -s/
Email .address:
SPEC IC DESCRIPTIO OF CORD:
FORMAT OF RECORD (if available)
0 I request to be notified when I can come to inspect the record(s) described above
^ I request copies of the records described above and agree to pay the cost of such records in
accordance with the fee schedule on the back of this application
^ I request that the records be -sent via a-mail to the address listed above
^ I request that the records be faxed to the number listed above